How Is Somatic Symptom Disorder Diagnosed?

Diagnosing somatic symptom disorder can be very difficult, because people with the disorder are convinced their symptoms are caused by a medical illness.

When symptoms appear, the doctor will begin his or her evaluation with a complete history and physical exam. If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. The psychiatrist or psychologist makes a diagnosis based on his or her assessment of the person's attitude and behavior, and the fact that physical illness has been ruled out as the cause of the symptoms. The psychiatrist or psychologist may administer a personality assessment to confirm the diagnosis of somatic symptom disorder.

How Is Somatic Symptom Disorder Treated?

A main goal of somatic symptom disorder treatment is to help patients live and function as normally as possible, even if they continue to have symptoms. Treatment also aims to alter the thinking and behavior that leads to the symptoms.

The disorder can be very difficult to treat. This is due, in part, to the fact that people who have it refuse to believe their symptoms are the result of mental or emotional rather than physical causes.

Treatment for somatic symptom disorder most often includes a combination of the following options:

Supportive care: In most cases, the best course of action is for the person to stay in regular contact with a trusted health care provider. Within this doctor-patient relationship, the doctor can monitor the symptoms and stay alert to any changes that might signal a real medical illness. The doctor's main approach is likely to focus on reassuring and supporting the person, and preventing unnecessary tests and treatments. It might be necessary, however, to treat some of the symptoms, such as severe pain.

Medications: Antidepressant or anti-anxiety drugs are sometimes used if a person with somatic symptom disorder also has a mood disorder or anxiety disorder.

Psychotherapy: Psychotherapy (a type of counseling), particularly cognitive therapy, can be helpful in changing the thinking and behavior that contribute to the symptoms. Therapy also can help the person learn better ways to deal with stress, and improve his or her social and work functioning. Unfortunately, most people with somatic symptom disorder deny there are any mental or emotional problems, making them fairly resistant to psychotherapy.